Wednesday, May 22, 2024

Microsort Gender Selection

MicroSort Gender Selection Related Frequently Asked Questions

In this section, you will access most frequently asked questions about the MicroSort procedure with their answers.

MicroSort is a sperm sorting technology that helps increase the likelihood of having a child of certain gender.

Because this technology only sorts the sperm, it is not a 100% accurate method of gender selection.

This rate of accuracy can only be provided by chromosomal screening on the embryos to identify the sex, which is offered by the Pre-Implantation Genetic Screening (PGS) technologies.

1- What is MicroSort®?

MicroSort® is the only scientifically proven preconception method that helps to increase the chances of having a boy or a girl. MicroSort® separates sperm into two groups: the sperm that produces a girl (X bearing) and sperm that produces a boy (Y bearing). This technology is only available in Mexico, Switzerland and Northern Cyprus. North Cyprus IVF Centre is the only certified clinic to offer MicroSort technologies to its patients and no other clinics in Cyprus have access to this technology.

2- What is the MicroSort® technology based on?

MicroSort® technology is based on the fact that the X chromosome is substantially larger than the Y chromosome. Human sperm cells having an X chromosome will contain approximately 2.8% more total DNA than sperm cells having a Y chromosome. The sort mechanism operates on this principle.

3- How does MicroSort® separate the sperm?

The sperm cells are separated with the help of a flow cytometer, using a special staining. The sample is processed then stained with a fluorescent dye, which attaches temporarily to the DNA in each sperm cell. The stained cells are then sent through the flow cytometer, where they travel single file through a laser beam that makes them fluoresce (glow). The X bearing sperm cells that took in more stain will glow brighter than the Y bearing cells that took in less stain. The computer software is able to identify the brighter (X bearing) and dimmer (Y bearing) glowing cells and direct the flow cytometer to select the cells requested to be sorted.

4- What is the Accuracy of the MicroSort procedure?

MicroSort is around 75% accurate for male sex selection and about 85% accurate for female sex selection. Therefore, it is not a 100% accurate method of gender selection. If a more accurate gender selection procedure is required, then Pre-Implantation Genetic Screening (PGS) will be the most appropriate treatment option.

5- How can the sorted sperm cells be used?

There are different ways the sorted sperm may be used:

  • a- Intrauterine Insemination (IUI): On the ovulation day the semen specimen is produced to be sorted. The intrauterine insemination with the sorted specimen takes place immediately after the sort. MicroSort IUI is the least invasive gender selection method that we recommend for fertile patients in their 20s. However, for patients over 30-32 years of age, IVF or PGD are more suitable as far as success rates are concerned. However, sometimes in early to mid-30s, if hormone levels are within an acceptable range, the IUI procedure can yield success. With the IUI procedure, there is a stage where a mild medication protocol is administered based on your hormone levels. With this stage, we aim to recruit a couple of good quality follicles for ovulation so that we can increase the chances of fertilization when the sorted sperm is actually injected intra uterine.
  • b- In vitro Fertilization (IVF) with optional Intracytoplasmatic Sperm Injection (ICSI): In this treatment option, the sorted specimen is used to fertilize the oocytes retrieved from the female patient. The embryos are then transferred into the uterus three/five days after fertilization.
  • c- IVF with optional ICSI and Preimplantation Genetic Diagnosis (PGD): As above, the sample can be sorted fresh or previously frozen. The sorted sample is used to fertilize the oocytes retrieved from the female patient. Once the embryos reach a certain stage of development, they are individualluy biopsied so that genetic testing can be administered for chromosomal screening so that an accurate gender selection with higher than 99% accuracy can be provided.

6- What is the minimum amount of cells needed for MicroSort®?

With IUI the minimum amount is 100 million Total Motile Cells (TMC), for IVF or ICSI the minimum amount is 70 million TMC. These values refer to the total amount of cells in the sample, regardless of the volume.
For IVF or ICSI the amount of cells can be achieved by freezing more than one ejaculate. If there are previous semen analysis, you can forward them to our lab and our staff will inform you if the amount of cells is above the limit or offer different options.

7- Can a sample be frozen and shipped to or from MicroSort® lab?

Yes, samples could be frozen and shipped to MicroSort® lab for sorting and/or shipped from the MicroSort® lab once they are sorted and frozen (Recommended just for IVF with optional ICSI cycles). Freezing and thawing does reduce the number of viable sperm cells available for sorting, it is recommended to freeze multiple ejaculates to give a total of at least 200 million TMC. In some cases, the patient may choose to travel to MicroSort® lab to produce a fresh specimen instead of freezing multiple ejaculates. Depending on the quality of the sample at least 100,000 TMC are frozen in each vial, when possible. If needed, we can put you in touch with a cryo shipper for the shipment of your sorted samples from our laboratory to the clinic of your choice.

8- Can a frozen sample be used for IUI?

Because of the reduced number of viable cells due to freezing and thawing, and the lower progression post thaw; only IVF and ICSI procedures are recommended for frozen sperm. Studies are under way to increase the viability of frozen sperm and hopefully IUI option will be offered in the future.

9- Can donor sperm be use for MicroSort® procedures?

Yes, donor sperm may be used for both IUI and IVF or ICSI in MicroSort®. Because of the high quality of donor sperm, and the high freezing and thawing proven capacity of the cells; the donor sperm may be able to be used for IUI.
For IVF or ICSI it is always possible to use a frozen donor sperm because of the low number of sperm the process requires.

10- How many sperm cells are sorted for each procedure?

In the case of IVF or ICSI with a fresh sample, only a few cells are required. When the procedure is done the same day of the sort, approximately 100,000 cells are sorted. More cells are sorted (300,000-500,000) if requested to freeze the remaining sample for further use. IVF or ICSI with frozen samples is used in the case the sperm is sorted in advance. When possible, multiple vials may be frozen from one sorted specimen. For this procedure depending on the quality of the specimen, at least 100,000 TMC are frozen in each vial. For IUI, depending on the quality of the sample a total of 300,000-500,000 sperm cells are sorted. On average the motility of the sorted samples is about 75 %, though this varies from individual to individual.

11- Why is MicroSort no longer available in the United States?

MicroSort is no longer available in the United States due to financial reasons. Since MicroSort is not a guaranteed 100% gender selection method, it had to be kept running on a clinical trial basis, and each year, Genetics and IVF Institute of Fairfax, Virginia, had to pay hundreds of thousands of dollars for keeping this technology running as a clinical trial. This was purely a cost/benefit analysis on the side of the founding company and the technology ceased to exist in the US but was expanded to Mexico, Switzerland and North Cyprus. It is not available in the EU countries for “ethical” reasons.